Dog presented for otitis externa. History included on and off vomiting- mainly food and bile for several weeks. Ususally at least once daily. Slight decrease in appetite (dog food), but will still eat human food (chicken etc.)
Dog presented for otitis externa. History included on and off vomiting- mainly food and bile for several weeks. Ususally at least once daily. Slight decrease in appetite (dog food), but will still eat human food (chicken etc.)
Comments
There is minor excessive gas
There is minor excessive gas pattern and minor excessive bowel thickness with minor microhepatica but needs further workup. Sonogram looking for GI disease, pancreatitis couple with bloodwork. If no vomiting check pain related disease as well such as disc spasms causing the poor appetite. If in the age range of addisons then could check a baseline cortisol as well.
Thank you very much for your
Thank you very much for your response.
There is minor excessive gas
There is minor excessive gas pattern and minor excessive bowel thickness with minor microhepatica but needs further workup. Sonogram looking for GI disease, pancreatitis couple with bloodwork. If no vomiting check pain related disease as well such as disc spasms causing the poor appetite. If in the age range of addisons then could check a baseline cortisol as well.
Thank you very much for your
Thank you very much for your response.
Our pleasure:)
Our pleasure:)
Our pleasure:)
Our pleasure:)
Would go for everything that
Would go for everything that Eric mention but a basal cortisol is not a great test and would do an ACTH stim if Addison’s is on the DDx list.
Would go for everything that
Would go for everything that Eric mention but a basal cortisol is not a great test and would do an ACTH stim if Addison’s is on the DDx list.
Question about the baseline
Question about the baseline cortisol. Is it not a reasonable way to rule out Addison’s? Of course, if low, it would have to be confirmed with an ACTH stim. test. Cost factors frequently lead me to do this if it is low on the differential list.
Thanks,
Suzanne
Question about the baseline
Question about the baseline cortisol. Is it not a reasonable way to rule out Addison’s? Of course, if low, it would have to be confirmed with an ACTH stim. test. Cost factors frequently lead me to do this if it is low on the differential list.
Thanks,
Suzanne
Yes its a screen only if
Yes its a screen only if less than 2.0 or even aaround that then you stim. If baseline cortisol is > 3.0 then its not usually addisonian… The cutoff at acvim presentation a couple of years ago was 2.0 (remo remember what year that was?) but I have seen bordeline cases that are 2.5 and stime something like 2.5/3.0… and respond to prednisone so there is that grey area.
Also beased on your studies on addisonian adrenals if they are flat and isoechoic I am also suspicious of addisons but adrenal burnout from chronic disease is a potential too.
See our work on this here in a few abstracts in resources:
http://sonopath.com/resources/articles
Good to know, thanks!
Good to know, thanks!
Yes its a screen only if
Yes its a screen only if less than 2.0 or even aaround that then you stim. If baseline cortisol is > 3.0 then its not usually addisonian… The cutoff at acvim presentation a couple of years ago was 2.0 (remo remember what year that was?) but I have seen bordeline cases that are 2.5 and stime something like 2.5/3.0… and respond to prednisone so there is that grey area.
Also beased on your studies on addisonian adrenals if they are flat and isoechoic I am also suspicious of addisons but adrenal burnout from chronic disease is a potential too.
See our work on this here in a few abstracts in resources:
http://sonopath.com/resources/articles
Good to know, thanks!
Good to know, thanks!